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Title: [A distal curved incision approach of lunula for treatment of subungual glomus tumor in nail root].
Author: Liu B, Chen W, Lu L.
Journal: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi; 2020 Oct 15; 34(10):1294-1297. PubMed ID: 33063496.
Abstract:
OBEJECTIVE: To investigate the feasibility and effectiveness of the distal curved incision approach of lunula in treating subungual glomus tumor in nail root. METHODS: Between March 2017 and October 2019, 16 patients (16 fingers) with subungual glomus tumor in nail root were treated. There were 2 males and 14 females with an average age of 35.3 years (range, 21-67 years). The disease duration ranged from 5 months to 17 years, with a median duration of 15 months. There were 6 cases of thumb, 3 cases of index finger, 2 cases of middle finger, 4 cases of ring finger, and 1 case of little finger. All of them showed typical "triad syndromes", and the cold sensitivity test and Love test were positive before operation. Each patient removed the nail, the tumor was exposed under the nail bed via the distal curved incision approach of lunula. After the tumor was removed completely, the nail bed was reducted in situ without suturing. The self-made nail template was pressurized and fixed on the surface of the nail bed with suture. The conditions of nail bed healing, pain, and growth of nail were observed after operation. RESULTS: All wounds of the nail bed with laceration healed by first intention. Postoperative pathological results confirmed the diagnosis of subungual glomus tumor in all the patients. All cases were followed up 3-26 months with an average of 15 months. The pain symptom disappeared and no obvious pain occurred during dressing change in all cases; and the cold sensitivity test and Love test were negative. The nails recovered smoothly with satisfactory appearance, and no obvious complications such as longitudinal ridge deformities or recurrences was observed. CONCLUSION: The treatment of subungual glomus tumor in nail root via the distal curved incision approach is an effective method, which can easily operated, resect the tumor completely, protect the nail bed effectively, and also has a significant effect on preventing postoperative nail deformity. 目的: 探讨应用经甲半月以远弧形切口治疗指甲根部甲下血管球瘤的可行性及疗效。. 方法: 2017 年 3 月—2019 年 10 月收治 16 例（16 指）指甲根部甲下血管球瘤患者。其中男 2 例，女 14 例；年龄 21～67 岁，平均 35.3 岁。病程 5 个月～17 年，中位病程 15 个月。拇指 6 例，示指 3 例，中指 2 例，环指 4 例，小指 1 例。均表现为典型“三联征”；术前冷敏感试验和 Love 试验均为阳性。患者均行全甲板拔除，经甲半月以远弧形切开甲床暴露瘤体，完整切除瘤体后，原位复位甲床不予以缝合，制作甲模板并原位回植，缝合加压固定。术后随访观察甲床愈合、疼痛、指甲生长等情况。. 结果: 术后患者切口均Ⅰ期愈合，术后病理检查均提示为甲下血管球瘤。所有患者均获随访，随访时间 3～26 个月，平均 15 个月。患指疼痛症状均消失，冷敏感试验和 Love 试验均为阴性；换药期间无明显疼痛。新生指甲平整光滑、外观满意，无明显纵嵴畸形等并发症发生；随访期间无 1 例复发。. 结论: 应用甲半月以远弧形切口治疗指甲根部甲下血管球瘤，操作简便、肿瘤切除彻底，术后复发率低，可有效保护甲床，预防术后指甲畸形，是一种有效手术方法。.

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